Individual
MS. CELESTE MARIE BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
04453
LA
2251G0304X
Geriatric Physical Therapist
04453
LA
2251X0800X
Orthopedic Physical Therapist
04453
LA
Other
Enumeration date
09/23/2013
Last updated
09/23/2013
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